Squamous cell carcinoma antigens SCCA1 and SCCA2 are highly homologous serine proteinase inhibitors which have been widely utilized as serological markers for squamous cell cancers, but it has recently been demonstrated that only SCCA2 is truly specific for certain forms of lung cancer. Using a construct containing the 5 0 -flanking region of the SCCA2 gene between À460 and þ 0 bp and the luciferase reporter gene, SCCA2 promoter activity was detected in SCCA2-producing SCC cell lines (LK-2, LC-1), but not in SCCA2-nonproducing lung adenocarcinoma cell lines (A549, ABC-1, and RERF-LC-MS) or normal cells (WI-38, SAEC, and NHEKAdult). Infection with a recombinant adenovirus vector, Ad-SCCA2-DsRed, resulted in cell-specific expression of the SCCA2 promoter-driven DsRed marker gene only in LK-2 and LC-1 cells. The same strategy was used for SCCA2-driven expression of a proapoptotic gene, (KLAKLAK)2, which can cause mitochondrial disruption by triggering mitochondrial permeabilization and swelling, resulting in the release of cytochrome c and induction of apoptosis. Infection with Ad-SCCA2-KLAKLAK2 specifically reduced the growth of the two human lung SCC cell lines compared to the SCCA2 nonproducing cell lines both in vitro and in vivo, suggesting that the SCCA2 promoter had a tumor-specific effect. These results suggest that transduction of SCCA2 promotercontrolled suicide genes by adenoviral vectors can confer transcriptionally targeted cytotoxicity in SCCA2-producing lung SCC cells, and represents a novel strategy for gene transfer specifically targeted to SCC in the lung. Cancer Gene Therapy (
IntroductionLung carcinoma is the most common malignant neoplasm and represents the leading cause of cancer death in the developed world. 1 Among lung carcinomas, adenocarcinoma and squamous cell carcinoma (SCC) are the most frequently encountered forms. Despite the use of optimal chemotherapy and radiotherapy regimens, there has been little improvement in the prognosis of these cancer patients during the last decade. 2,3 This underscores the need to seek novel therapeutic modalities for lung cancer patients. One such approach is gene therapy by administration of vectors expressing cytotoxic genes; however, in order to maximize tumor-killing efficacy and minimize any potential adverse effects of this approach, it would be advantageous to employ a cancer-specific targeting strategy. For adenocarcinomas in general, transcriptional targeting by the use of cancer-specific promoters such as the carcinoembryonic antigen (CEA) promoter has been described previously. 4,5 However, little has been reported for SCC-specific regulation.The squamous cell carcinoma antigen (SCCA) was first reported by Kato et al. 6 in 1977 as a circulating tumor marker for SCC, particularly that of cervix, head and neck, esophagus, and lung. 7 Several studies have shown that increased serum SCCA levels are seen in SCC patients 8,9 and correlate with the extent of disease in patients with SCC, 10,11 although the protein itself is not detected in adenoca...